title: Percutaneous endoscopically assisted transenteric full-thickness gastric biopsy: initial experience in humans.
abstract: BACKGROUND
  GI neuromuscular diseases (GINMD) can cause severe dysmotility and symptoms. Full-thickness biopsy specimens may help diagnose these disorders histologically.
  
  
  OBJECTIVE
  To assess a novel percutaneous endoscopically assisted transenteric (PEATE) biopsy method for obtaining full-thickness gastric tissue in patients with suspected GINMD.
  
  
  METHODS
  Prospective proof-of-concept case series.
  
  
  METHODS
  Tertiary care gastroenterology unit.
  
  
  METHODS
  Ten patients (8 women, mean [standard deviation] age 43 [10] years) with gastroparesis-like symptoms (mean [standard deviation] gastroparesis cardinal symptom index 3.28 [1.46] out of 5) and/or clinical findings suggestive of a gastric GINMD.
  
  
  METHODS
  All patients underwent PEATE biopsy during standard gastroscopy as an outpatient procedure. Tissue was stained for histology and immunohistochemistry of gut wall elements. Interstitial cells of Cajal (ICC) counts were compared with archived normal gastric tissue from control gastrectomies.
  
  
  METHODS
  Biopsy success, complications, histopathological findings according to the London Classification of GINMD.
  
  
  RESULTS
  Full-thickness antral tissue suitable for analysis was obtained in 9 in 10 patients (90%). PEATE biopsy was well tolerated by all patients without complications. Histology suggested GINMD in 4 of 9 cases (44%), with possible degenerative leiomyopathy in 2, probable inflammatory leiomyopathy in 1, and abnormal ICC networks (>50% reduction in ICC counts) in 1 patient.
  
  
  CONCLUSIONS
  PEATE biopsy specimen size is smaller than a standard laparoscopic full-thickness biopsy.
  
  
  CONCLUSIONS
  PEATE full-thickness gastric biopsy is a simple and safe method of assessing histopathological abnormalities in gastric GINMD without the need for laparoscopy or general anesthesia.
authors.affiliation: Centre for Digestive Motility, Division of Gastroenterology, Department of Medicine, University of Calgary, Medical Clinic, Calgary, Alberta, Canada. candrews@ucalgary.ca
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Andrews
authors.forename: Paul
authors.initials: P
authors.lastname: Mintchev
authors.forename: Emil
authors.initials: E
authors.lastname: Neshev
authors.forename: Hughie F
authors.initials: HF
authors.lastname: Fraser
authors.forename: Martin
authors.initials: M
authors.lastname: Storr
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Bathe
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Urbanski
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D004415:Dyspepsia / Q000175:diagnosis* / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005746:Gastric Emptying; D005753:Gastric Mucosa / Q000473:pathology*; D018589:Gastroparesis / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results